Is Prehospital Advanced Life Support Harmful?
Authors: Jason S. Haukoos, Comilla Sasson
Journal: Annals of Internal Medicine (2016)

Letters5 July 2016Is Prehospital Advanced Life Support Harmful?Jason S. Haukoos, MD, MSc and Comilla Sasson, MD, PhDJason S. Haukoos, MD, MScFrom Denver Health Medical Center, Denver, and University of Colorado School of Medicine, Aurora, Colorado.Search for more papers by this author and Comilla Sasson, MD, PhDFrom Denver Health Medical Center, Denver, and University of Colorado School of Medicine, Aurora, Colorado.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L16-5011 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We believe that Sanghavi and colleagues' study (1) adds nicely to the discussion about the effectiveness of emergency medical services systems in the United States and highlights potentially important areas where further scientific work is needed. However, we are not convinced that their results are definitive or conclusive. Results from observational data, including large, administrative data sets, may supplement practice and policy, but by their very nature tend to be limited (2, 3). We believe that more specified prospective research, including use of quasi-experimental, cluster randomized, and pragmatic methods, must serve as the scientific framework for understanding the ...References1. Sanghavi P, Jena AB, Newhouse JP, Zaslavsky AM. Outcomes of basic versus advanced life support for out-of-hospital medical emergencies. Ann Intern Med. 2015;163:681-90. [PMID: 26457627]. doi:10.7326/M15-0557 LinkGoogle Scholar2. Tatsioni A, Bonitsis NG, Ioannidis JP. Persistence of contradicted claims in the literature. JAMA. 2007;298:2517-26. [PMID: 18056905] CrossrefMedlineGoogle Scholar3. Ioannidis JP, Haidich AB, Pappa M, Pantazis N, Kokori SI, Tektonidou MG, et al. Comparison of evidence of treatment effects in randomized and nonrandomized studies. JAMA. 2001;286:821-30. [PMID: 11497536] CrossrefMedlineGoogle Scholar4. Stiell IG, Nesbitt LP, Pickett W, Munkley D, Spaite DW, Banek J, et al; OPALS Study Group. The OPALS Major Trauma Study: impact of advanced life-support on survival and morbidity. CMAJ. 2008;178:1141-52. [PMID: 18427089] doi:10.1503/cmaj.071154 CrossrefMedlineGoogle Scholar5. Stiell IG, Wells GA, Field B, Spaite DW, Nesbitt LP, De Maio VJ, et al; Ontario Prehospital Advanced Life Support Study Group.. Advanced cardiac life support in out-of-hospital cardiac arrest. N Engl J Med. 2004;351:647-56. [PMID: 15306666] CrossrefMedlineGoogle Scholar6. Stiell IG, Spaite DW, Field B, Nesbitt LP, Munkley D, Maloney J, et al; OPALS Study Group.. Advanced life support for out-of-hospital respiratory distress. N Engl J Med. 2007;356:2156-64. [PMID: 17522399] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Denver Health Medical Center, Denver, and University of Colorado School of Medicine, Aurora, Colorado.Grant Support: Dr. Haukoos was supported in part by R01AI106057 (National Institutes of Health) and R01HS021749 (Agency for Healthcare Research and Quality).Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M15-2192. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoIs Prehospital Advanced Life Support Harmful? Comilla Sasson and Jason S. Haukoos Is Prehospital Advanced Life Support Harmful? Prachi Sanghavi , Anupam B. Jena , Joseph P. Newhouse , and Alan M. Zaslavsky Metrics 5 July 2016Volume 165, Issue 1Page: 71KeywordsAllied health care professionalsDisclosureHealth care qualityHealth services researchHeartResearch quality assessment ePublished: 5 July 2016 Issue Published: 5 July 2016 Copyright & PermissionsCopyright © 2016 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...